The present disclosure relates to systems and methods for delivering an irrigant to the frontal sinus of a patient. More particularly, it relates to systems and methods for surgically treating the frontal sinuses, for example in removing bacterial biofilms.
Bacterial biofilms develop in a variety of bodily cavities, including those of the ear, such as the middle ear, and those of the nose, such as the frontal or maxillary sinuses, for example. Once bacterial growth has been established, the bacteria will often aggregate, stop dividing, and begin forming protective bacterial biofilm layers, or “slime layers,” comprised of polysaccharide matrices.
The protective bacterial biofilm interferes with the body's natural immune response as well as traditional methods of treatment. In particular, the bacteria emit exotoxins, which incite the body's immune system to respond with white cells. However, the bacterial biofilm interferes with the efficacy of the white cells' ability to attack the bacteria. The biofilm can also act as a barrier against topically administered antibiotics and other medicaments. Biofilm-forming bacteria also present obstacles to traditional, antibiotic treatments that act to kill dividing bacteria. In particular, the bacteria in a biofilm-forming state may have already ceased cell division, rendering such antibiotics largely ineffective.
Functional endoscopic sinus surgery (FESS) is a minimally invasive surgical procedure used to treat chronic rhinosinusitis, and possibly other infections of the sinuses. FESS opens up sinus air cells and sinus ostia (openings) with an instrument aided by an endoscope. The use of FESS as a sinus surgical method has now become widely accepted. The purpose of FESS is typically to restore normal drainage of the sinuses and to allow their ventilation. However, FESS does not address the bacterial biofilm concerns described above.
While ventilation surgery may incidentally cause some biofilms to slough off, many remain after surgery and it has been postulated that further therapies are required to remove bacterial biofilms in the paranasal sinuses and other bodily locations. In this regard, systems have been contemplated that act to destroy bacterial biofilm via delivery of a pressurized irrigant. Examples of such systems are described in commonly-assigned U.S. patent application Ser. No. 11/697,789. With these, as well as other sinus irrigation procedures unrelated to biofilm removal, certain target sites present anatomical barriers that may impede use of various instruments.